Tenet Healthcare Corporation (THC)

Tenet Healthcare owns hospitals but earns above all from outpatient surgery centres.

A hospital is a hard business: the emergency department must accept anyone, a substantial share of patients do not pay, and staffing costs rise faster than reimbursement. Profitability is modest and depends on the insurance mix of those who arrive.

Outpatient surgery centres are built the opposite way: scheduled procedures on insured patients, short stays, a predictable calendar and costs markedly below a hospital's. Medicine itself is shifting into that format, and the company steadily raises its share of it while selling hospitals. Risks: government programme reimbursement and clinical labour costs. The company pays no dividend.